Success Rate Of Endodontic Treatment Research Articles

Cyclic Fatigue of Different Ni-Ti Endodontic Rotary File Alloys: A Comprehensive Review.

Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel-titanium instruments has become widespread and consolidated, a success due primarily to the alloy's mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics. The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture. At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy. The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.

The Influence of NiTi File Design Features on the Apically Extruded Debris During Endodontic Treatment A concise reviews

Expelling debris and irrigating solution during cleaning and shaping is an inevitable incidence during endodontic treatment. Any irritation of the periapical area can initiate a flareup situation which can affect the prognosis of endodontic treatment. Thus, Controlling the amount of apically extruded debris increases the success rate of endodontic treatment. Furthermore, the incidence of flare-ups during endodontic treatment can be reduced by selecting the NiTi file system with the lowest apically extruded debris. Despite the advances in endodontic file design that aims to conservatively prepare the apical third of root canals, extruding debris toward the apex is still a non-eliminated issue with all instrumentation systems. The purpose of this review is to identify the effect of each design characteristic on the amount of debris expelled beyond the apical foramen. The strategy of this review focused on reviewing specific electronic databases, time, keywords, and standardized methods. Literature reviewing included studies from almost 20 years ago and up to 2022. In conclusion, the design of the NiTi endodontic file has a significant impact on the amount of apically extruded debris.

The Effect of Tooth Location on the Success and Failure of Endodontic Treatment: A Systematic Review

Endodontic treatment is preferred to save the inside of the tooth, which is being infected by bacteria. There are many factors that can influence the outcome of an endodontic treatment. One of the most challenging factors is the anatomy of the tooth itself on which the endodontic treatment is planned. The location and type of tooth and structure of the root canal influence the anatomy of the tooth. This study aims to determine the effect of tooth location on the success rate of an endodontic treatment from the existing literature. Eight studies were included in this review with a total sample size of 6,056 patients who underwent endodontic treatment. All studies showed the outcome of endodontic treatment in the context of tooth type. Studies were consistent with the fact that the overall success rate of endodontic treatment is higher in anterior incisors as compared to premolars and molars owing to the number of canals per tooth and the comparative operational difficulty between incisors and molars while performing an endodontic treatment. Therefore, the findings in this review suggest that tooth location is a significant factor that can influence the outcome of endodontic treatment.

Long-term follow-up of equine incisor endodontic treatments using an orthograde technique.

This retrospective clinical study was performed to determine the suitability and success rate of endodontic treatment of equine incisors presenting with apical and periapical disease. All horses presented to a referral equine dental clinic between March 2013 and December 2019 specifically selected as candidates suitable for endodontic treatment were included in this study. Initial clinical and radiographic presentation of incisor disorder cases suitable for endodontic treatment were recorded (88 incisors) and follow-up examination for long-term viability (8 months to 5 years) was performed in cases involving 32 incisors in total. A total of 68 horses with 88 incisors were included in this study for endodontic restorative treatment. Different dental materials were used, with a temporary 3-layered technique using calcium hydroxide apically and temporary cement and resin composite occlusally most commonly used at the first treatment. Complete obturation with resin composite was performed in 48% of the cases requiring second treatments (50 incisors). Follow-up examination involving 32 incisors showed that successful endodontic treatment was achieved in 75% of the teeth treated. Endodontic treatment of diseased incisors is a viable option in equid patients with a success rate comparable to humans in practice. The use of flowable resin composite as an obturation material has been shown to be successful at either the second treatment or in carefully selected patients at the first treatment.

Middle mesial canal - A mystery in mandibular first molar: Report of two cases

Endodontic therapy aims at disinfection of the root canal system. Efforts are made by root canal instrumentation and chemical disinfection to remove the infected pulp tissue and debris from the root canal space. However due to variations in canal anatomy, it is impossible to instrument all the parts of canal and that may lead to persistence or progression of infection. Thorough knowledge of tooth morphology is important to improve the success rate of endodontic treatment. Missed canals are considered to be an important factor for endodontic failure and about 4% cases treated by specialists also reported have shown to have missed canals. Hence use of all the available methods to detect the additional aberrant canals and disinfection of them during root canal treatment procedure is essential for favorable endodontic outcome.

Morphometric relationships in mesio-buccal roots of maxillary first molars in Saudi subpopulation: A CBCT study.

This CBCT-based study analysed morphometric relationships in Mesio-Buccal (MB) roots of maxillary first molars (MFM). 133 MFM with two MB canals were assessed and classified using Vertucci's classification. MB roots' length and MB1-MB2 canals inter-orifice distances (IOD) were noted. The data were analysed using SPSS software. The most frequently present canal was type IV (59.4%) followed by type II (40.6%). Mean MB roots' length for canals exhibiting type IV was 9.26 ± 0.21 mm and of those exhibiting type II was 12.8 ± 0.42 mm. Statistically significant relationship was found between MB root length and canal type. Mean IOD for type II and type IV canals was 2.4 ± 0.47 and 3.8 ± 0.21 mm, respectively. Statistically significant relationship was found between IOD and canal type. Length of MB root and IOD had a significant association with canal type present in MFM. This knowledge can enhance clinicians' understanding of canal morphology which can increase predictability and success rate of endodontic treatment.

Evaluation of mesiobuccal root canal morphology and interorifice distance in maxillary first molar teeth: a CBCT study on Southeast Anatolian population

Aims: The aim of this study was to evaluate the mesiobuccal root canal morphologies and interorifice distances of maxillary first molars using cone-beam computed tomography (CBCT). 
 Methods: CBCT images of 477 patients who had undergone CBCT for various reasons were examined and 654 maxillary first molars were included in the study according to the study criteria. 
 Results: The most common canal configuration observed in mesiobuccal roots was type II (p < 0.05). The median interorifice distance was 2.28 mm in roots with type II canal configuration, while it was measured as 2.55 mm in roots with type IV canals, and a significant difference was found depending on the presence of canal in the apical third of the root (p < 0.001). The median interorifice distance was found to be 2.58 mm in males and 2.34 mm in females, and a significant difference was detected (p < 0.001). 
 Conclusion: Various canal variations can be observed in the mesiobuccal roots of maxillary first molars, and the length of interorifice distance can predict the canal type. This information can increase the success rate of endodontic treatment.

Patient Satisfaction and Oral Health-Related Quality of Life before and after Endodontic Treatment: A Longitudinal Study.

Patient satisfaction depends on various factors despite a reasonable success rate of endodontic treatment. We study various factors affecting the quality of life and patient satisfaction post-endodontic treatment. After the successful endodontic treatment of 250 patients, a questionnaire with means of an interview by the examiner was carried out and recorded. The majority of the patients were satisfied. Mean oral health quality was more satisfactory post one-month study. Oral health quality among anterior and posterior was not significant. Oral health quality among the upper and lower jaw was not significant. Oral health quality among males and females was not significant. A concrete relationship exists between the diseased state and its treatment on quality of life.

The effect of periapical lesion size on the success rate of different endodontic treatments: a systematic review and meta-analysis

This systematic review evaluated the effect of periapical lesion (PL) size on the success rate of different endodontic treatments, including root canal treatment (RCT), non-surgical retreatment (NSR), and apical surgery (AS). Cohorts and randomized controlled trials investigating the outcomes of endodontic treatment of permanent teeth with PL and its size were identified electronically through Web of Science, MEDLINE, Scopus, and Embase databases. Two reviewers independently conducted the study selection, data extraction, and critical appraisal process. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale and the 11-item Critical Appraisal Skills Program checklist for randomized controlled trials. The success rates of the endodontic treatments (small lesions and large lesions) were estimated using the rate ratios (RRs) with an associated 95% confidence interval (CI). Out of 44 included studies, 42 were cohort, and 2 were randomized controlled trials. Thirty-two studies had poor quality. For the meta-analysis, five studies in RCT, 4 in NSR, and 3 in AS were considered. The RR of the endodontic treatment success in PLs was 1.04 in RCT (95% CI, 0.99-1.07), 1.11 in NSR (95% CI, 0.99-1.24), and 1.06 in AS (95% CI, 0.97-1.16). Only sub-group analysis of long-term follow-up of RCT showed a significantly higher success rate in small lesions than in large lesions. Considering the quality of studies and variation in outcomes and size classification, our meta-analysis demonstrated that the PL size had no significant effect on the success rate of different endodontic treatments.

Evaluation of Antimicrobial Activity of Newly Prepared Calcium Oxide Based Nanosealer Using Agar Diffusion Test


 Aim of the study: The antimicrobial activity of a root canal sealer can increase the success rate of endodontic treatments. The key of antimicrobial properties of calcium based sealers laid in their composition and alkalinity. The invention and applications of newer materials are quintessential in every field especially in endodontics. This reality has led to growing interest in the use of biomaterials products that comprised of both mineral and organic components as those in the teeth. This study was performed to assess the antibacterial activity of newly prepared calcium oxide based nanosealer and compare the result with BioRoot sealer
 Materials and methods: The CaO nanopowder was firstly prepared from calcinated cowrie seashell using ball milling and ultrasonic irradiation methods, and then the CaO nanopowder was used as the main component in the preparation of an experimental nanosealer powder part. After several pilot studies, the final formula for the prepared sealer that gave the best clinical sealer consistency and properties within the limits of ANSI/ADA Specification No.57/2012 was as the following. The powder part consists mainly of nano CaO (44%) in addition to glutamic amino acid, zirconium oxide (20nm), and silica oxide (15-20) nm, while the liquid part consists mainly from distilled water in addition to propylene glycol. The Antimicrobial activity of the prepared sealer was evaluated by agar diffusion test against E.faecalis and E.faecium, after 1, 2, 3, and 7 days of incubation at 37˚C. Zone of bacterial inhibition was measured and analyzed statistically using Independent sample t – test at (p=0.05) levels.

Location angle of second mesio-buccal canal in maxillary molars of an Indian population: an in vivo retrospective CBCT evaluation and proposal of a new classification.

BackgroundThe current investigation was designed for predicting the location angle of second mesio-buccal root canal in permanent maxillary (first and second) molars with the aid of proposed measuring points and line using cone beam computed tomography in an Indian population.MethodsThree-hundred and twenty-four scans of permanent maxillary (first (n = 162) and second (n = 162)) molars with mesio-buccal 2 root canals and unassociated to the current evaluation were acquired. The maxillary molars were viewed with CSI imaging software. The images were captured and were further assessed using 3D Slicer. The assessment included of measuring the distance between the main mesio-buccal and mesio-buccal 2 canal and the angle at which the MB2 it is located utilizing proposed lines joining the disto-buccal and palatal canals. The data was tabulated for the incidence of various angles where the MB2 is located and MB-MB2 distance was determined. The angles denoted were either positive; I (0.1° to 1.9°), II (2° to 4°), III (>4°) or negative I (−0.1° to −1.9°), II (−2° to −4°), III (>−4°). On the data tabulated a new Banga Vhorkate and Pawar’s (BVP’s) angular classification for maxillary molars was proposed.ResultsThe existence of positive angle III was found in 41.35% of maxillary first molars (36 right and 31 left of 162), whereas positive angle II appeared in 41.98% of maxillary second molars (32 right and 36 left of 162). The MB1–MB2 in maxillary 1st molar is seen to be 3.12–3.31 mm and this distance in maxillary 2nd molar is 2.8–3.1 mm. The disto-buccal to palatal canal orifice mean distance was 5.06–5.22 mm in maxillary first molars and 4.9–5.8 mm in maxillary second molars.ConclusionAccurate diagnosis of the location of second mesio-buccal canal increases the success rate of endodontic treatment and a better prognosis. The new proposed classification may be considerably helpful in the urge to locate the mesio-buccal 2 canal.

Outcome of endodontic treatments performed by Brazilian undergraduate students: 3- to 8-year follow up.

ObjectivesThis study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome.Materials and MethodsA follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level.ResultsThe success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17–9.54).ConclusionsThe success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

Outcomes of the GentleWave system on root canal treatment: a narrative review.

This study aimed to describe the outcomes of the GentleWave system (GW) (Sonendo) on root canal treatment. Published articles were collected from scientific databases (MEDLINE/PubMed platform, Web of Science, Scopus, Science Direct and Embase). A total of 24 studies were collected from August/2014 to July/2021, 20 in vitro and 4 clinical. GW System was not associated with extrusion of the irrigant, promoted faster organic dissolution than conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI) continuous ultrasonic irrigation (CUI) and EndoVac, reduced more bacterial DNA and biofilm than PUI and CUI, promoted higher penetration of sodium hypochlorite into dentinal tubules than PUI and CUI in vitro, and removed more intracanal medication than CSI and PUI. GW was able to remove pulp tissue and calcifications. Moreover, its ability to remove hard-tissue debris and smear layer was better than that of CSI, and its ability to remove root canal obturation residues was lower or similar to that of PUI, and similar to that of CSI and EndoVac. Regarding root canal obturation of minimally instrumented molar canals, GW was associated with high-quality obturation. Clinically, the success rate of endodontic treatment using GW was 97.3%, and the short-term postoperative pain in the GW group was not different from CSI. Further research, mainly clinical, is needed to establish whether GW has any advantages over other available irrigation methods.

Analysis of endodontic success using a Periapical Index in teeth with different types of intraradicular posts

This randomized clinical trial evaluated the influence of the type of intraradicular posts (glass fiber post or cast metal post) in the success of endodontic treatment in teeth that received single metal-ceramic restoration. The sample consisted of adult patients, who presented for the first time seeking routine dental care at the dental school over a period of 5 years. Seventy-six out of ninety-six teeth that received endodontic treatment and intraradicular post were analyzed, randomly distributed in two groups – glass fiber post (n=38), and cast metal post (n=38). The quality of the endodontic treatment was radiographically evaluated, and the apical status was assessed using the periapical index (PAI). Statistical Analyses were performed to a significance level of 5%. Descriptive analyses were used to characterize the teeth and survival curves were created using the Kaplan–Meier method. The success rate of endodontic treatment was 90.8% (n=69) including glass fiber post and cast post. When appropriate endodontic treatment was performed is possible to conclude that the success of endodontic treated teeth that received posts was not related to the post type.

Biocompatibility of Styrene-butadiene Copolymer-modified Calcium Phosphate and Mineral Trioxide Aggregate

The biocompatibility of root canal filling material is one of the basic conditions for a successful endodontic treatment and healing of the periodontium. This study was aimed to evaluate the biocompatibility of calcium phosphate cement modified with the styrene-butadiene copolymer-modified calcium phosphate (mCPC) by its implantation in the subcutaneous tissue of rabbit. Fifteen female rabbits of comparable weight were used in this study, each one had received three different tubes; one containing mCPC, the other with mineral trioxide aggregate Fillapex, and an empty control tube on the subcutaneous tissue of thighs. After a definite time (3, 7, and 14 days), the tissues around the tubes were collected, fixed, and processed for histologic evaluation. A histopathological specialist measured the intensity of inflammation. Kruskal–Wallis test was used to analyze the data. The results showed a significant difference with mCPC group in different periods, there was a high intensity of inflammation at the beginning, then it fell, and sustained as mild inflammation. One can conclude that the new formulation of CPC considered biocompatible, which rises the success rate of endodontic treatment.

In vivo Biocompatibility and Bioactivity of Calcium Silicate-Based Bioceramics in Endodontics.

Endodontic therapy aims to preserve or repair the activity and function of pulp and periapical tissues. Due to their excellent biological features, a substantial number of calcium silicate-based bioceramics have been introduced into endodontics and simultaneously increased the success rate of endodontic treatment. The present manuscript describes the in vivo biocompatibility and bioactivity of four types of calcium silicate-based bioceramics in endodontics.

Endodontic Retreatment In Case Of Failure: Case Report

Background: In medical practice, clinicians come across a lot of obstacle during a treatment , that can lead to a failure, like other dental treatments, endodontics too can fail. Inappropriate mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal filling, and coronal leakage are some of the commonly attributable causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases and most of the times can be attributed to the already stated causes. Purpose: Endodontic retreatment of a failure is required by the increased desire to preserve the tooth on the dental arch, preventing the need for dental extraction that may have adverse consequences in terms of functional and psychological effect on patients. Case: This article presents a case report about dental retreatment with 2 common failure, that was under filling obturation and non-fit post. Case management: The failure was corrected with endodontic retreatment, and finally restored with fiber post and porcelain fused to metal crown. Conclusion: Endodontic retreatment was done successfully on underfilling obturation and non-fit post. The patient was satisfied with the result.

SUCCESS RATE OF ENDODONTIC TREATMENTS PERFORMED BY UNDERGRADUATE STUDENTS OF THE UNIVERSITY OF SOUTHERN SANTA CATARINA

Introduction: Apical periodontitis is an inflammatory disease of the periradicular tissues caused by microbial (re)contamination of the root canal system. Due to its direct relationship to the quality of endodontic treatment, it is extremely important to carry out longitudinal and cross-sectional studies, following-up treatments carried out in universities. Aim: To evaluate the success rate of endodontic treatments performed by undergraduate students of the University of Southern Santa Catarina - UNISUL, Pedra Branca, between August 2015 and July 2017. Materials and Methods: One hundred twenty-four patients with endodontic treatment were contacted. Of these, only 27 attended for treatment follow-up, adding up to a total of 32 treatments analyzed. All teeth were clinically and radiographically evaluated, and the potential indicators related to endodontic treatment success or failure were analyzed. The frequencies of each criterion were calculated, and the data analyzed using the Chi-Square test (α = 5%). Results: 9 cases (28.13%) were considered failure, either because they were associated with symptoms or because there was a periapical alteration. In addition, 88.88% of the failure cases had temporary restorative material. Association was observed only between the number of root canals and symptoms (P = 0.049). Two of the 3 treated teeth with multiple root canals showed symptoms at the follow-up. The endodontic success rate was 71.87%. Conclusion: The success rate of the 32 endodontic treatments performed by undergraduate students from UNISUL was 71.87%.

Association of ankylosing spondylitis with radiographically and clinically diagnosed apical periodontitis: A cross-sectional study.

There are no studies evaluating the possible association between ankylosing spondylitis (AS) and apical periodontitis (AP). The aim of the present cross-sectional study was to investigate the possible association between AS and AP. Fifty patients diagnosed with AS, receiving treatment at the Rheumatology Clinic in Erzurum, Turkey, were included in the experimental group. Another 50 ageand gender-matched individuals without any history of systemic disease were included in the study as the control group. All patients were examined radiographically and clinically to diagnose the presence of AP. The following data was recorded for all patients: the smoking habit, the number of teeth present, the number of teeth with AP, the number of root canal-treated (RCT) teeth, and the number of RCT teeth with AP. There were 1,283 teeth in the AS group and 1,305 in the control group. There was a significant association between teeth with AP and AS, as the prevalence of teeth with AP was significantly lower in the control group (1.3%) than in the AS group (2.9%) (OR (odds ratio) = 2.250; p = 0.005). There was no statistically significant difference between the groups in terms of the number of RCT teeth and RCT teeth with AP (p > 0.05). Ankylosing spondylitis is significantly associated with an increased prevalence of AP. It can be concluded that patients with AS can be more prone to develop AP. However, AS does not reduce the success rate of endodontic treatment, because there was no significant difference between the AS and control groups in terms of RCT teeth with AP.

Success Rate of Endodontic Treatment in Mandibular First Molar Performed in A Clinical Setup - A Retrospective Data on One Year Evaluation

Conservation of a patient's natural teeth remains an important outcome in securing oral health. Endodontic treatments have been shown to successfully retain compromised teeth which are fractured, carious or traumatised. Outcomes of dental treatments as explained in the literature fall into four categories: success, survival with intervention, survival without intervention and failure. The success or failure in endodontic therapy is still problematic for the clinician. Improper mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal obturating material, and coronal leakage are some of the commonly associated causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a greater number of cases and most of the times can be attributed to the already stated causes. With an ever-increasing number of endodontic treatments being done each day, it has become difficult to avoid or minimize the most fundamental of reasons prominent to endodontic failure. A total of 1096 cases have been selected for the study with parameters like single visit root canal treatment, multi visit root canal treatment, and extractions. Data was collected from reviewing patient records and analysed the data between June 2019 and March 2020. In this study, we observed that root canal therapy has a success rate of 97.9% (1073 teeth) and 2.7% (23 teeth) failure in mandibular first molars ( > 0.05). Within the limitations of the study, root canal therapy has a higher success rate but one cannot totally rely on one single factor that will decide the success of a treatment. More research is required with enhanced study designs before long term success rates can be correlated.